189: I have just received a letter from a patient. He has asked me why I didn’t refer him at his last eye examination with me a year ago. He went to another eye specialist and has been diagnosed with primary open-angle glaucoma. He has been told that he has had glaucoma for around two years. I’ve looked in his clinical records and there is a copy of a referral letter but I can’t remember if I told him I was referring him as a glaucoma suspect. What should I do?

Two of my current medico-legal cases involve claims by patients that they weren’t told by their eye specialist that they were being referred for suspect eye problems. One...

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188: One of my male patients has just presented complaining of no vision in his right eye. He noticed it about an hour ago when he woke up but is not sure if it has been there longer. This is the first time he has experienced this. He is 66 years old, overweight and is taking medicine for high blood pressure. His left visual acuity is ‘perception of light’. What is going on?

This sounds very much like a right central retinal vein occlusion. The most common cause is a blood clot, which prevents the flow of blood along the vein. Other causes include...

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